The continued decline of formal urological education of medical students in the United States: does it matter?

Objective: Survey analyses of 50 years document a substantial decline in the formal urological education of United States medical students, resulting in repeated calls by urologists to reverse this trend. Has this trend continued during the last decade? If so, should we be concerned? We performed a national survey to provide an updated assessment of urological education at United States medical schools.

Methods: All 321 applicants to the 2003 to 2004 United States urology residency match and 527 applicants to a Boston area emergency medicine residency program in 2003 to 2004 from accredited United States medical schools were invited to participate in the study. On a validated, anonymous online survey, these students were asked 1) did their school offer a required and/or elective clinical rotation in urology, and 2) if so, what was its duration and in which year was it usually completed.

Results: Curricular data were obtained on 110 of 125 (88%) accredited United States medical schools. Of United States schools 17% (17.3%, SE 1.2%, 19 of 110) have required clinical rotations in urology; these required rotations are 1 to 2 weeks in duration and, in 79% of cases, conducted in year 3 of medical school. Those medical schools that require a clinical rotation in urology do not have a greater percentage of their students entering the urology match (Mann-Whitney U test p = 0.540).

Conclusions: Formal urological education of United States medical students has continued to erode during the last decade, but the impact of this trend on student learning and career choice is not clear. Further research is required to determine whether these changes are of concern for the quality of applicants to urological training and for the future of urological care in the United States.